In some embodiments, a cell collection device includes a sample brush including a proximal end, a distal end, and outwardly extending bristles provided at the distal end, and an outer sleeve adapted to receive the sample brush, the sleeve including a proximal end and a distal end, wherein the sleeve can be linearly slid along the length of the brush to encapsulate the bristles after they have been used to collect cells from a patient.
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1. A method for collecting cells from an anus of a patient, the method comprising:
obtaining a cell collection device comprising a sample brush including an elongated shaft having a distal end and radially extending bristles provided at the distal end and a tubular outer sleeve through which the elongated shaft extends, the outer sleeve including a distal end including a distal tip having a distal opening from which the distal end of the elongated shaft and its bristles extend;
inserting the distal end of a sample brush extending from the distal tip of the outer sheath into the anus;
rotating the sample brush while the distal end of the brush is within the anus to collect cells with bristles provided at the distal end of the brush;
withdrawing the sample brush from the anus;
linearly moving the outer sleeve relative to the sample brush or vice versa such that the bristles of the brush extending from the distal opening of the outer sleeve are retracted into the outer sleeve;
inserting the distal end of the outer sleeve along with the bristles into a cell collection liquid; and
rotating the sample brush relative to the outer sleeve or vice versa to enable the bristles of the brush to alternately extend from bristle windows positioned at the distal end of the outer sleeve and retract into the outer sleeve, wherein the extension and retraction of the bristles causes cells collected by the bristles to transfer to the cell collection liquid.
2. The method of
3. The method of
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This application claims priority to U.S. Provisional Application Ser. No. 62/206,407, filed Aug. 18, 2015, which is hereby incorporated by reference herein in its entirety.
Anal cancer is a serious disease that affects many. Early detection of anal cancer or pre-cancer is critical. Currently, testing is performed using a cotton or polyethylene terephthalate (PET) swab. The swab is inserted into the anus and the physician moves the swab from side to side while simultaneously rotating the swab about its longitudinal axis. The goal is to collect cells that can be either transferred to a liquid or to a slide to enable examination of the cells under magnification.
There are several disadvantages to the above-described procedure. Although the swabs collect cells well, it can be difficult to transfer those cells to a liquid or a slide because the cells tend to get trapped in the fibers of the swab. Furthermore, the sample technique is relatively complicated and is subject to great variability between physicians. As a consequence of these issues, the swab method has poor sensitivity in detecting cancer. In one study, it was determined that the use of swabs was ineffective in identifying cancer in as many as 92% of anal cancer patients. In addition, swabs can be uncomfortable to patients and, therefore, can provide motivation for such patients to avoid an anal exam.
In view of the above discussion, it can be appreciated that it would be desirable to have an alternative device for collecting cells from the anus for the purpose of screening for anal cancer.
The present disclosure may be better understood with reference to the following figures. Matching reference numerals designate corresponding parts throughout the figures, which are not necessarily drawn to scale.
As described above, it would be desirable to have an alternative device for collecting cells from the anus for the purpose of screening for anal cancer. Described herein are cell collection devices that can be used for that purpose and that provide improved results. In some embodiments, a cell collection device includes a sample brush that fits within an outer sleeve. A distal end of the brush extends from a distal end of the sleeve and includes bristles that are optimized for collection of cells from the anorectal transformation zone. The sample brush can be inserted, while within the outer sleeve, into a patient's anus until the bristles are no longer visible and the brush can be rotated about its longitudinal axis to collect cells. Once the sample brush has been withdrawn from the anus, the sleeve can be pushed distally along the length of the brush until the sleeve encapsulates the bristles. The sample brush can then be rotated and/or linearly moved relative to the outer sleeve to separate the cells from the bristles. In some embodiments, this can be performed while the distal end of the sleeve and brush are immersed in a liquid cell collection medium so as to transfer the cells to the medium. Optionally, windows through which the bristles can extend can be provided at the distal end of the sleeve to facilitate such transfer.
In the following disclosure, various specific embodiments are described. It is to be understood that those embodiments are example implementations of the disclosed inventions and that alternative embodiments are possible. All such embodiments are intended to fall within the scope of this disclosure.
Extending axially from the tip of the tapered portion 32 at the distal end 28 of the shaft 24 are twisted wires 33, shown most clearly in
Provided at the distal end of the twisted wires 33 beyond the bristles 34 is a contoured tip 36. In the illustrated embodiment, the tip 36 has an elliptical shape in which the longest dimension of the tip aligns with the longitudinal axis of the shaft 24. In some embodiments, the tip 36 is also made of a polymeric material and has a lateral diameter of approximately 4 to 5 mm. In some embodiments, the length of the “insertion section,” which includes the bristles 34 and the tip 36, is approximately 4.0 to 4.5 cm long. As is discussed below, that length is the approximate insertion depth of the sample brush 12.
With further reference to
With reference next to
Once the cell collection device 10 has been removed from the patient, the sleeve 14 can be pushed distally along the length of the brush 12 (overcoming the connection provided by the detent 40) so that the sleeve will encapsulate the bristles 34 of the brush, as shown in
After the bristles 34 have been pulled into the sleeve 14, the distal ends of the sample brush 12 and the sleeve can be immersed in a cell collection medium, such as a suitable liquid. The brush 12 can then be rotated relative to the sleeve 14 or vice versa to transfer the collected cells from the bristles 34 to the collection medium. During this rotation, some bristles 34 will extend through the windows 38 while others that were extending through the windows will be retracted back into the sleeve 14. This alternate extension and retraction, and the beveled edges 39 of the windows 38, facilitates transfer of the collected cells to the collection medium. After several rotations, for example, back-and-forth rotations, have been performed, the cell collection device 10 can be removed from the collection medium and discarded.
The cell collection device 10 described above provides several advantages over the swabs that are currently used for anal cancer screening. First, the collection process is greatly simplified. Because of the optimized length and diameter of the insertion section of the sample brush 12, cells can be collected from the desired region (e.g., the anorectal transformation zone) without guesswork. Because of the length and distribution of the bristles 34, cells can be collected with as little as a single rotation of the brush 12 and without lateral pressure or repeated passes. As a result, the sample process can be standardized and variability in the results from physician to physician can be minimized. Furthermore, the sleeve 14 provides for encapsulation of the bristles after insertion and the relative rotation of the sleeve and the brush 12 enables easy and safe transfer of the collected cells from the bristles 34 to the collection medium. Moreover, the shape of the brush tip 36, the nature of the bristles 34, and the manner in which the brush 10 is manipulated to collect cells translates into improved patient comfort during the cell collection procedure.
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